Contributing to Global Health: Development of a Consensus-Based Whole Systems Research Strategy for Anthroposophic Medicine

• Published in: Evidence-based complementary and alternative medicine 2019, Vol.2019 (2019), p.1-14
• Main Authors: Szöke, H., Wolf, U., Kiene, Helmut, Kapócs, G., Falkenberg, T., Cuadrado Nahum, C., Berger, B., Ben-Arye, E., Kienle, Gunver, Martin, David D.
• Format: Article
• Language: English
• Subjects: Alternative medicine; Analysis; Art therapy; Case reports; Clinical decision making; Clinical trials; Decision making; Global health; Health promotion; Health services; Hospitals; Integrative medicine; Lifestyles; Medical personnel; Meditation; Nursing; Patient-centered care; Patients; Psychotherapy; Public health; Qualitative research; Research methods; Sensory integration; Strategy; Sustainable development; Technology assessment; Values; Well being; World health
• ISSN: 1741-427X; 1741-4288
• DOI: 10.1155/2019/3706143

Background. Whole medicine and health systems like traditional and complementary medicine systems (T&CM) are part of healthcare around the world. One key feature of T&CM is its focus on patient-centered and multimodal care and the integration of intercultural perspectives in a wide range of settings. It may contribute to good health and well being for people as part of the Sustainable Development Goals of the United Nations. The authentic, rigorous, and fair evaluation of such a medical system, with its inherent complexity and individualization, imposes methodological challenges. Hence, we propose a broad research strategy to test and characterize its possible contribution to health. Methods. To develop a research strategy for a specific T&CM system, Anthroposophic Medicine (AM), applying multimodal integrative healthcare based on a four-level concept of man, we used a three-phase consensus process with experts and key stakeholders, consisting of (1) premeeting methodological literature and AM research review and interviews to supplement or revise items of the research strategy and tailor them to AM research, (2) face-to-face consensus meetings further developing and tailoring the strategy, and (3) postmeeting feedback and review, followed by finalization. Results. Currently, AM covers many fields of medical specialties in varied levels of healthcare settings, such as outpatient and inpatient; primary, secondary, and tertiary care; and health education and pedagogy. It is by definition integrated with conventional medicine in the public healthcare system. It applies specific medicines, nursing techniques, arts therapies, eurythmy therapy, rhythmical massage, counseling, and psychotherapy, and it is provided by medical doctors, nurses, therapists, midwives, and nutritionists. A research strategy authentic to this level of complexity should comprise items with a focus on (I) efficacy and effectiveness, divided into (a) evaluation of the multimodal and multidisciplinary medical system as a whole, or of complex multimodal therapy concept, (b) a reasonable amount of methodologically rigorous, confirmatory randomized controlled trials on exemplary pharmacological and nonpharmacological therapies and indications, (c) a wide range of interventions and patient-centered care strategies with less extensive formats like well-conducted small trails, observational studies, and high-quality case reports and series, or subgroup analyses from whole-system studies, or healt